Collision Science, Creative Thinking,
and Hope for Treating
Meet Our New Research Director: Ken Pienta
Pienta's website (kenpienta.com) features this quote from Mahatma Gandhi: "You must be the change you wish to see in the world." He is the author of more than 350 journal articles and has been the lead investigator of many clinical trials; he has twice received the American Cancer Society's Clinical Research Professor Award. But throughout his career, Pienta has tried to avoid ever becoming the stereotypical ivory tower academic type, jealously hoarding his research until the next peer-reviewed publication comes out. Early on, Don Coffey taught him to be generous with what he learned. "He always said to make sure to disseminate what you know, and not to worry about being scooped," says Pienta. "I have always tried to stay true to Don's philosophy. At Michigan, when we collected prostate tissue through our tissue acquisition program we gave samples freely throughout the world whenever researchers asked. Over the years, that eventually led to many scientific discoveries." This way of thinking also led Pienta toward what he calls "collision science" – basically, "taking folks from disparate disciplines and getting them to work together at solving problems in the field we are interested in." Although Pienta's own specialty is in treating and studying prostate cancer, "one of my closest research collaborators is a dentist." Why? Dentists are bone biologists, Pienta explains, and that's where advanced prostate cancer tends to spread – the bone.
Pienta has also studied "cooperation theory," as it applies to cancer research, with a professor in the School of Public Policy at Michigan. This collaboration has led to a half-dozen projects Pienta has ongoing with biomedical engineers. "We are trying to create little gadgets that will help us get cells out of the blood." As Director of Research at the Brady, Pienta is fostering an environment where this kind of out-of-the-box thinking and multidisciplinary collaboration can thrive. It has to, he says. "So many of the researchers who trained at the Brady over the years are now directing or working at top-notch programs at other institutions. This creates strong competition, which is good. If we want to remain number one, we have to be the best by continuing to make new and important discoveries and working even harder." Pienta, who was named Distinguished Mentor of the Year in 2009 by the American Urological Association, believes that his role is to understand "what everyone's goals are and then figuring out how best to help each one achieve them."
Pienta's own research centers around what he calls "ecosystems" in metastatic cancer. "One of the reasons I came back to the Brady is to accelerate the pace of my own discoveries and come up with an effective ecological therapy that will modify the environment where the cancer cells are found." Most American men who are diagnosed with prostate cancer are cured by surgery or radiation, he notes, "but unfortunately, about 30,000 men still die of metastatic disease in this country every year. Many new drugs for metastatic prostate cancer have been approved in the last three years, but right now, we can't cure metastatic prostate cancer," and the reason may be that the drugs target the wrong aspects of cancer. "The majority of these therapies attack mutations in the cancer cells." But Pienta has come to believe that tumors can be viewed as ecosystems "where the cancer cells are intimately interacting with a variety of normal cells." In this microenvironment of a tumor within the body, he adds, it's the plain old regular cells that help the cancer grow and spread. The interaction of these cancerous and normal cells actually remodels the microenvironment. "Think of it as an evolving ecosystem," he explains. "We are using this model to design new treatments for metastatic prostate cancer," developing combination drugs that directly target the cancer cells and also attack the microenvironment. "For example, we discovered that almost half of cells in metastatic cancer sites are ‘tumor associated macrophages' – cells that should not even be there and have been attracted there to try and clean up the damage being done to the normal tissue by the cancer." Once these cells have been lured to the cancer site, they are co-opted – impressed, like the Shanghaied sailors of old – by the cancer cells to help the tumor grow. "We have already conducted two trials to block these macrophages as a way to treat prostate cancer and are working on multiple new therapies. We refer to this as ecological therapy for cancer."
Pienta is excited about the promise of these multi-targeting drugs. "There is great potential for us to make an exponential leap if we solve issues of drug combinations and figure out how to use targeted therapy correctly. I believe we will discover many innovative treatments, and transition them all the way from the bench to the bedside."